A case series on live ectopic pregnancy

Abstract

A pregnancy which develops outside uterus is called ectopic pregnancy that comprises nearly two percent of total pregnancies. In first case a 25years old female presented with lower abdominal pain and bleeding per vagina with 3 months of amenorrhea and history of irregular oral contraceptive pill use. A live ectopic pregnancy of 12 weeks 3 days gestation found on right fallopian tube during laparotomy and right salpingectomy was done. In second case, a third gravida mother presented with bleeding per vagina and lower abdominal pain with history of 2.5 months of amenorrhea and chronic pelvic inflammatory disease. During laparotomy, both sided hydrosalpinx and left sided live ectopic pregnancy found on the distal end of fallopian tube and left salpingectomy with fimbriectomy with right sided tubal ligation was done. In third case, a third gravida mother with history of lower uterine caesarean section and ruptured left sided tubal ectopic pregnancy previously, presented with lower abdominal pain with 2 months of amenorrhea. Ultrasonography diagnosed a live right sided cornual ectopic pregnancy of 6weeks 6days and conservative management with injection methotrexate was started. Later due to sudden hemodynamic instability, emergency laparotomy was done and ruptured right cornual ectopic pregnancy was found and treated with total abdominal hysterectomy. All these cases were managed successfully. This case series emphasizes that early serological and sonographic diagnosis of location of pregnancy is necessary, there should be high suspicion for ectopic pregnancy even beyond the first trimester and the decision of conservative management in early ectopic pregnancy should be taken judiciously after checking all parameters of the patient.